MEDICARE: ADVANCED PODIATRIC MEDICINE & SURGERY, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	213E00000X	Podiatrist	N005278-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PCWB51	OTHER	NY	AARP
2	VANESSA DARMOCHWAL	OTHER	NY	INDECS
3	PCWB51	OTHER	NY	FIRST UNITED AMERICAN LIF
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	10035850	OTHER	NY	CDPHP
6	NY9999	OTHER	NY	MUTUAL OF OMAHA
7	P1034534	OTHER	NY	OXFORD
8	150605577	OTHER	NY	AMERICAN PROGRESSIVE
9	2C6599	OTHER	NY	HEALTHNET
10	9108	OTHER	NY	GHI
11	P10831	OTHER	NY	EMPIRE BLUE CROSS BLUE SH
12	989630	OTHER	NY	MVP

General Provider Information

NPI Number	:	1275623266
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED PODIATRIC MEDICINE & SURGERY, P.C.

Provider Business Mailing Address
First Line	:	3725 US HIGHWAY 9W
Second Line	:
City	:	HIGHLAND
State	:	NY
Zip	:	12528-2041
Country	:	US
Telephone Number	:	845-691-9388
Fax Number	:	845-691-9068

Provider Business Practice Location Address
First Line	:	3725 US HIGHWAY 9W
Second Line	:
City	:	HIGHLAND
State	:	NY
Zip	:	12528-2041
Country	:	US
Telephone Number	:	845-691-9388
Fax Number	:	845-691-9068

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. VANESSA MARY DARMOCHWAL
Credential	:	D.P.M
Telephone Number	:	845-691-9388

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	04/20/2008

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